Matias B. Yudi et al. JACC 2018;71:

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Presentation transcript:

Matias B. Yudi et al. JACC 2018;71:1360-1378 CT Analysis Pre–Left Main Intervention (A) The commissural posts (yellow arrows) are clearly not in front of the left main coronary artery, and the diamond is open at the top of the left main orifice (2 blue dots). (B) The diamond narrows down at the base of the left main orifice (blue dots). (C) The left main coronary artery origin is 14.0 mm from the annular plane (blue double-headed arrows) and 23.4 mm from the base of the Evolut-R (Medtronic, Galway, Ireland) (yellow double-headed arrows); thus, the skirt (13 mm in height) will not interfere with left main engagement. (D) Nonselective, but diagnostic angiogram was performed using JR4 catheter showing left main stenosis (red arrow). (E) An Ikari Right 1.0 guide (white arrow) was used with a guide extension catheter (red arrow) for extra support to perform the left main PCI. (F) Post-dilation of the implanted left main stent was performed with a 4.0-mm balloon, which extended through valve diamonds to ensure that the ostium was treated optimally. CT = computed tomography; JR = Judkins right; PCI = percutaneous coronary intervention. Matias B. Yudi et al. JACC 2018;71:1360-1378 2018 American College of Cardiology Foundation